,*•-. i *»••;/ , ■■■■■■ •■■■;. ^•v:ivr; S* A'A. V •'V'i;.., ?•>*■• ./ * ^jf£SSi»^r LIBRARY Author: GREAT BRITAIN. General Board of Kepor^1 the General Board of Health Tide: on the administration of public health -act — and the Acc. Neals*, 71188 ances remov actPat<184E 1854 and -1^4' ume O'*— REPORT OF TUB GENERAL BOARD OF HEALTH ON TUB ADMINISTRATION OF THE PUBLIC HEALTH ACT AND THE NUISANCES REMOVAL AND DISEASES PREVENTION ACTS, feom 1848 to 1854. IDrcSeutctr ter Lotlj $nus'e3 of ^parliament iy Comiuatrtf of $?cr j$Ujc£ty. LONDON : PRINTED BY GEORGE E. EYRE AND WILLIAM SPOTTISWOODE, rniNTEKS TO THE QUEEN’S MOST EXCELLENT MAJE8TT. POR HER MAJESTY’S STATIONERY OFFICR. LIST OF CONTENTS. Introduction ------ Course taken with respect to Cholera Epidemics Mode of Dealing with Premonitory Symptoms Results of Houso-to-House Visitation - Influence on the Progress of the Epidemic Quarantine - Preparations for Discontinuing Intramural Interments - Preparations for a more Economical and Efficient Supply of Water Local Applications for the Public Health Act Expenditure for Sanitary Improvement of Towns Reported state of Local Works under Local Acts previous to th passing of the Public Health Act - Wasteful Outlays in Inefficient Works New System required for Town Drainage - - - New Principles of Water Supply - Application of Sewage as Liquid Manure - Contracts fulfilled within the Estimates - - - Progressive Demand for and Advantages of Pipe Drains - Improved Local Administration - - Works of Trading Companies as compared with those of Muni cipalities ------ Aids given to Works for Sanitary Improvement - Indications of Benefits from Complete Works Reduction of Rates of Mortality from complete House Drainag Works alone - Effects of the Waste from Excessive Mortality, &c., on the Physica Condition of the Population - Effects of the Waste of Adult Life by excess of Mortality, &c. as well as by Emigration - Expense of New Works to Private Persons Want of Information by Towns, &c. Comparative Expense and Securities of Legislation by Provisional Orders as compared with Local Acts - Table shewing Cost of Works on the Old and New Systems Incompleteness of the Public Health Act to meet Special Cases Objection to alleged Interference with Local Boards Objection as to the Employment of Engineering Inspectors, &c. Influence of Public Works on Public Health Comparison of Expenditure with Sums voted A 2 PAGH 5 6 8 9 10 11 12 13 14 15 16 18 19 20 21 22 23 24 25 26 27 28 30 32 35 36 38 40 41 43 44 46 47 iv LIST OF CONTENTS. PAGE 48 Extensive Interests unavoidably interfered with, &c. - Organised Misrepresentation of New Works spread through the Country ------- Saving in Expenso of Legislation by Local Acts - Attendances of Members of General Board - Work in Preparation ------ Recapitulation of Progress made in the Execution of the Public Health Act ------- Need of Protection for unrepresented Classes - Additional Powers needed - - Extent of Attention to the Subject abroad Appendices . No. 1. Conclusions obtained with respect to Cholera No. 2. Conclusions obtained with respect to Yellow Fever No. 3. Conclusions obtained with respect to Quarantine No. 4. Conclusions obtained as to Metropolitan and Suburban Interments ------ 1. Metropolitan Interments - 2. Extramural Interments in Country Towns No. 5. Conclusions obtained on Water Supply No. 6. Table of comparative Results obtainable from new and old Modes of Water Supply - - - No. 7. Conclusions obtained as to House Drainage, and the Sewerage and Cleansing of Sites of Towns No. 8. Conclusions obtained as to Drainage of Suburban Lands No. 9. Conclusions obtained on Application of Sewer Water and Towns Manures to Agricultural Production No. 10. Tests for the Examination of Candidates for the Office of Superintending Engineering Inspectors of the General Board of Health - No. 11. Instructions of the General Board of Health to the Superintending Inspectors No. 12. Statement of the Business transacted by, and the Expenditure of, the General Board of Health, from its Foundation in 1848 to 31st December 1853 No. 13. Table showing Deaths and Causes of Death in 1S47 No, 14. Table showing Comparison of the Cost in Life of War and Pestilence and Civil Violence - - - 112 49 52 54 56 GO 61 63 64 63 69 71 71 73 76 - 86 88 90 90 - 94 - 96 102 109 General Board of Health, My Loud Whitehall, 6th January 1854. The term for which we were appointed to administ e the Public Health Act now drawing to a close, we beg leave to present, for the information of your Lordship, the following statement of the progress made in the execution of that Act, and of the present state of the business of this Board. Though the administration of the Public Health Act formed our special and paramount duty, we have been required under the Nuisances Removal and Diseases Prevention Act to devote much attention to several objects of immediate and great urgency, of which it may be proper first to give a brief account. Shortly after entering on our office the calamity of a second outbreak of pestilential cholera appeared to be impending, and the threatened danger was soon realized. This pestilence has again, for a third time, appeared, and the part we have been called upon to take with reference to both of these epidemic visitations will, we apprehend, when duly examined, afford means of judging of the public demands for administrative service, such as that which has devolved upon us. Returns from the registration districts of England and Wales, show that, on the last visitation of 1848 and 1849, about 72,000 persons fell victims to cholera and choleraic disease during the epidemic. It is known that these returns were not accurate, as also that many deaths occurred which were not registered. In several instances information as to partial outbreaks was suppressed, and there is reason to believe that in many towns, in ill-drained and neglected districts, occupied by the poorer classes, numerous deaths really produced by epidemic cholera, were either not known to have been so caused, or were registered as caused by other diseases. In Scotland there are no registration returns, but the mortality from the pestilence in that part of the kingdom is believed to have been greater in proportion to the population than in England. It is probable that not fewer than between 80,000 and 90,000 persons in the whole of Great Britain perished by To the Right Honourable Viscount Palmerston , G.C.B., M.P., fyc. fyc. SfC. 6 Course taken with respect to Cholera Epidemics. this disease, and, reckoning three attacks to one death, that upwards of a quarter of million were the subjects of the disease in its developed form. It is estimated that of those who died in England and Wales, 30,000 were adult persons of both sexes in the vigour of life. In the last twenty-two years’ war the number of British who were killed in actual battle, including those who fell both in the army and navy, was under 20,000 (19,796), so that there perished in a few months by this one epidemic 10,000 more persons in the prime of life than fell in battle during the whole of the last war. — (See App. No. 14.) In Newcastle and Gateshead, during the recent out- break, the mortality has been nearly three times greater than it was in the metropolis in the epidemic of 1848-9, and during the last four months,* even in the metropolis, the deaths from cholera have nearly doubled the number registered in the corresponding period of 1848. If the pestilence in 1854 spread through the country as it did in 1849, and prove as mortal in its entire course as it has done at its recommencement, there will have perished by the end of next year upwards of 100,000 persons, including in this destruction probably as large a number of the young and able-bodied as have been enrolled in the militia. At the cessation of the epidemic of 1849, the loss of life was as if an entire county, like Cardigan or Huntingdon, had been deprived of the whole of its population. At the termination of the impending visitation the loss may be equal to that of the depopu- lation of two such counties. In twelve unions in England in which that epidemic caused 11,170 deaths, returns show that there were 3,567 widows and orphans. The charge upon the rates for the maintenance of persons thus pauperised, for four years only, would probably amount to about 121,000/. At the same rate, the 72,000 deaths in England and Wales would give 23,000 widows and orphans of the class chargeable to the poor rates, and involve for their relief an expenditure of 780,000/. for the like period of time. If * In the period (from January to March) which has elapsed since the presentation of this report, there has been a more decided lull in the progress of the epidemic than occurred in 1848-9, so that at the present period the deaths are somewhat less than in the corresponding period of 1848. In the first six months of the epidemic of 1848 the deaths in the metropolis amounted to 988 ; in the corresponding period of the epidemic of 1853 they number 802. Course taken with respect to Cholera Epidemics. 7 to these sums be added the expense of funerals, of medical attendance, and of relief to those who were attacked but recovered, and if Scotland be included, the pecuniary cost of this visitation, (exclusive of the cost to Ireland,) could not have been less than 2,000,000/. Under the Nuisances Removal and Diseases Prevention Act we were charged with the duty of devising and administering measures for mitigating and checking the spread of cholera. An examination of the results of the preventive measures which were adopted will show that they exercised a very decided influence in checking the progress of the pestilence. In other countries where no such measures were resorted to, and where the predisposing and aggravating local conditions could hardly have been more intense than in the neglected districts of many of our own towns, the mortality in proportion to the population was, in several instances, much more than double that of Newcastle, the only town in England in which the disease has, in 1853, been epidemic. In Stockholm, for example, the deaths in round numbers were 31 in 1,000 of the population. In Copenhagen they were also 31 in 1,000. In Warsaw they were 35 in 1,000; and in Christiana they were also 35 in 1,000. But in Newcastle, during the recent outbreak, although this has been the severest that has yet occurred in this country, they were 17 in the 1,000. If the mortality in England and Wales, from cholera, in 1849, had been at the average rate of that which has lately occurred in the places above enumerated, the deaths instead of being 72,000 would have been near 600,000. That the visitation of 1848-9 was greatly mitigated by the preventive measures that were adopted, will be evident on a consideration of the results set forth in our report on cholera (pp. 143 to 149), and these results, as will be seen below, are confirmed by the recent experience of Newcastle and other northern towns (App. 1, p. 64). The demands made upon us for assistance on the first outbreak of the epidemic in 1848, rendered it urgently necessary that we should apply ourselves to the subject. Inquiries under the Metropolitan Sanitary Commission appeared to us to have ascertained facts which determined the proper mode of dealing with the pestilence. These investigations, exhibiting the course of the disease in pre- vious attacks, and the results of the experience of medical 8 Mode of Dealing with Premonitory Symptoms. witnesses who attended the greatest numbers of the sick, in the districts most severely ravaged, had proved, be- yond all question, that in the immense majority of cases the violent and unmanageable form of cholera is not sudden in its approach, but is preceded by a premoni- tory stage, generally of some hours and often of several days’ duration, and that in this stage the disease is con- trollable. On the other hand, from the experience we had collected from countries and climates the most diversified, it appeared that if this stage be neglected, and the de- veloped stage allowed to come on, one half, or even two thirds, under unfavourable, and one-third under the most favourable circumstances, of those attacked, are certain to perish, whatever may be the mode of treatment adopted. On these facts we endeavoured to base a system of pre- vention. In order to discover the disease in its earliest stage, and to bring it immediately under proper treatment, we organized a system of house-to-house visitation, so as to place the inmates of every poor man’s house in infected districts under daily medical inspection. We moreover proposed the opening of dispensaries, at which, in the absence of the visitors, the poor might be pro- vided with medicines at any hour, night and day; and also the opening of houses of refuge for the temporary reception of the inmates of filthy over-crowded houses, in which cholera had either actually broken out or was impending ; and we further advised that the medical visitors should be made instrumental in discovering and reporting nui- sances, and pointing out the houses and localities which stood in the most urgent need of cleansing. At first much difficulty was experienced in bringing these combined measures into operation, but as the epi- demic advanced the system was extensively adopted, and in many instances energetically and efficiently applied. The following is a summary of the results: — 130,000 persons in the first stage of cholera were by its means discovered and placed under immediate treatment. Of this number 6,000 were on the point of passing into developed cholera, yet only 250 or about 1 in 500 actually did so. Of the whole number brought under visitation in the metropolis (43,737) 978 were on the point of passing into cholera, but only 52 actually did so ; so that, on the whole, the numbers which passed from the premonitory into the developed state ranged from one in 500 to one in 800. In the much severer visitation which has recently taken Results of House-to-Ilouse Visitation. 9 place at Newcastle the results are similar. The returns show that during this outbreak 44,6 1 1 persons, suffering from diarrhoea and cholera, received relief under this preventive system, but it must be borne in mind that man}' persons were relieved more than once, so that some deduction from the above number must be made. The total number of persons discovered in Newcastle, by the house-to-house visitation, in a state of cholera or choleraic disease was 5,497. Of these there were in diarrhoea 5,160; approaching cholera, 271; cholera, 66. The visitors also discovered the corpses of three persons who had died without receiving any medical aid. Of the 5,1 60 cases thus discovered in the first stage, 17 passed into the second stage; and of the 271 in the second, 13 passed into the third stage, or into developed cholera ; that is, about one in 300 passed from diarrhoea into approaching cholera, and nearly five in 100, or one in twenty, passed from approaching cholera into cholera. These results mark the greater severity of the out- break at Newcastle than that in the metropolis in 1849, where, as has just been stated, only one in 800 of the cases of diarrhoea passed into cholera. It is remarkable, however, that in the stage approaching cholera the pro- portion that went into cholera was nearly the same in both epidemics, this event happening in 1848 in one case in nineteen, and at Newcastle in one case in twenty. The influence of the house-to-house visitation in check- ing the progress of the pestilence at Newcastle is shown by the following facts : On the first week in which the visitation came into complete operation, there were under the care of the medical officers 333 cases of cholera, and 321 of approaching cholera. In the second week these fell to 76 cases of cholera, and 132 of approaching cholera. In the third week only 6 cases of cholera and 48 of approaching cholera could be discovered. In the next three weeks the visitors found but 5 cases of cholera, and 51 of approaching cholera, and the total number of cases treated by the medical officers amounted only to 47 cases of cholera and 86 of approaching cholera. The medical inspector reports, “ These were, for the “ most part, isolated and scattered cases ; in the infected “ districts the disease was as effectually extinguished as “ a fire would be by a sufficient water fall.” 10 Influence on the Progress of the Epidemic. It is important to bear in mind, as showing that this sudden and rapid diminution of cases was owing in a very great degree to the preventive measures enforced, and only in a subordinate degree to the natural decline of the disease, that, while cholera and approaching cholera fell from 333 to 76 and from 499 to 180, diarrhoea still prevailed, according to the testimony of all the medical men engaged in this service, in as severe a form as before, and in the proportion of 3,398 to 2,327, exclusive of the cases which received aid at the newly opened dispensaries. The diminution was in fact nearly 77 per cent, in the cholera cases ; 64 per cent, in the cases approaching cholera; and only 31 per cent, in the diarrhoea cases. In the town of Stockton-upon-Tees a violent outbreak of cholera occurred between the 5th and 7th of October. The house-to-house visitation began on the 7th and ended on the 20th. During this period there were discovered 503 cases of diarrhoea, 16 approaching cholera, and 11 cholera. Of this total number only 1 1 ended in death ; the whole of the cases of diarrhoea, together with those of approaching cholera, having been stopped from ad- vancing to the developed stage of the disease. We believe the difference in the proportionate mortality in the towns in which this system was carried into effect, compared with that in towns where no such measures were adopted, whether in this country or abroad, affords a measure of the amount of life which this system was the means of saving. It may be further stated, that one invariable effect of the system, wherever brought into operation, was to put an end to panic. The people finding they were cared for, and knowing definitely where and how to apply for assistance in the moment of need, became tranquil, and confidence was restored. Medical officers generally both at home and abroad have expressed their conviction of the efficiency of this system of prevention. The College of Physicians have concurred in recom- mending its adoption. Local authorities, instead of resisting its application as they did in 1848, have recently, in numerous instances, applied for advice and assistance in preparing for its organization. The orders of the Board are more closely and generally executed. The complaints commonly re- Quarantine. 11 ceived now arc of the insufficiency of the powers conferred for accomplishing the objects of the Legislature. From Scotland we have received applications to order works of a permanent nature. Petitions for the application of the Public Health Act have increased. The medical inspec- tors state that they find a marked change in the towns they visit, compared with the feeling which was very general in 1848 ; that the local authorities are now anxious to give efficient action to the orders and regulations of the Board, and that they themselves universally receive votes of thanks and urgent requests to repeat their visits. The Poor Law Boards of Guardians, the Inspectors of the Poor Law Board, the Union medical officers, the Local Boards of Health, and the Boards’ medical inspectors are now brought into a far better state of union than in 1848, and join in willing and cordial co-operation. The officers under the Board of Customs and the Board of Trade, the officers under the Emigration Commis- sioners, and the medical staff of the Admiralty will, we have reason to believe, be better prepared than in the last epidemic to give aid on a recurrence of outbreaks in the ports. The Ordnance will, we expect, be ready again to aid with the use of tents, should outbreaks occur at the season of the year when tents can be used, to tent out the population from the infected districts, — >a practice which has been found of signal advantage. Recent experience has strengthened our conviction that the service rendered on the occasion of these local out- breaks, to be at all effectual must be immediate. In ordinary civil service, the delays occasioned by multiplied refer- ences and the fulfilment of routine forms, may do little harm, and are borne patiently ; but in the case of the application of measures for the repression of epidemic disease, all delay involves the extension of sickness, and the infliction of pain, misery, and preventible death ; and therefore when plainly attributable to any public depart- ment, tends to make public administration odious to the people. It was during our direction of preventive measures against the spread of cholera, that our attention was called to the fatal consequences resulting from the isolation of cholera patients, in an infected atmosphere on board ship, under quarantine regulations, and to the total inefficiency of quarantine as a safeguard against this disease. 12 Preparations for discontinuing Intramural Interments. We deemed it our duty to investigate the subject as closely and extensively as we could, and we embodied the conclusions at which we arrived in a Report on Quarantine, which, having been translated into Italian and French, and widely circulated on the continent, mainly contributed to the conference held at Paris, with a view to the reconstruction and reform of the existing system of quarantine. — (App. No. 3, p. 69.) Having, under the authority of the Nuisances Removal and Diseases Prevention Act and by direction of Her Majesty’s Government, been required to frame a schemeof Extramural Interment for the metropolis, we carefully investigated all we could find to have been done abroad with respect to the economical and respectful performance of this service. While we kept in view the importance of the essential object, that of putting an end to the physical and moral evils resulting from the practice of burying the dead in the midst of the living, we could not treat the disposal of the last remains of the dead as if they were a mere nuisance to be got rid of in any way. We regarded the service, on moral and religious, as v7ell as physical, grounds, as a ser- vice to be elevated. We objected to depriving the parish- ioner of his right to interment in the parochial burial ground, without providing for him an equivalent under public sanction, or to leaving his necessities to the mercy of trading speculation. We also objected to enforcing this great and necessary reform without making provision for compensation to those who might appear to have a just claim to it, as suffering grievous and irrevocable loss from the change. We endeavoured to secure the removal of the dead in such a manner as should be soothing to the friends and relations of the deceased, without being offensive to strangers, or the general inhabitants by the conveyance of the remains in excessive numbers through crowded thoroughfares. To abate the evil of retaining the dead body in the living and sleeping rooms of the survivors, we planned reception rooms on what we believed to be a new, appropriate, and efficient construction. We believed we had provided against the extension of the old evils to new suburbs. We still believe that these objects might be secured without levying rates, with full compen- sation where compensation is due, and with a reduction of one half of the existing expense of funerals. Though the scheme presented was accepted by Her Majesty’s Government, and its main principles sanctioned by the Legislature, yet the powers required for carrying it iuto For a more economical and efficient Supply of Water. 13 effect were not granted by Parliament ; we were, therefore, unable to render it available for putting an end, so completely as we believed from the facts investigated to be practicable, to the great and growing evils of intramural interment. While we are confirmed in our views by the subsequent general representations of the great body of the clergy, founded on the continued experience of evils which it has been the object of the Legislature to remove, we have, on application from the Home Department, given, as it was our duty to do, every advice and aid in our power for the due execution of the existing law. Apart, however, from the questions as to the particular measures which the evidence rendered it our duty to recommend, we believe that compensation will be received for the time occupied, from the principles elicited or confirmed for the improved management of places of public interment, which will be available for the guidance of local authorities, as well as of those of our inspectors who have been engaged in the execution of the existing law. We were further requested by the Secretary of State for the Home Department, to investigate and report on the whole subject of a more efficient and economical supply of water for the metropolis. In compliance with this direction, we endeavoured to devise a scheme which might supply the metropolis with pure, soft, spring water, instead of hard, polluted, river water ; by constant instead of intermittent service, combined with works for carrying away waste water, and this at so reduced a cost that every house in the poorer districts might have its supply of water at a price not exceeding two pence per week. This has been effected for several towns, under the Public Health Act, and may be ultimately effected for all towns under that Act. We expressed our conviction, which we still retain, that there are no insuperable difficulties in the way of accomplishing the same results for the metropolis. — ( See Reports and Minutes on new Sources of Water for the Metropolis, and new Modes for its Collection. — Also, App. No. 5 and No. 6.) But for these extraordinary demands on our time and attention, we might now have had the satisfaction of reporting a greater number of towns in the enjoyment of the powers and privileges of the Public Health Act, and these in a state of greater forwardness with their works ; yet, considering that the labour in which we have been 14 Local Applications for the Public Health Act. engaged is the first attempt to carry into practice a principle of legislation entirely novel, and that the staff of superintending inspectors to conduct the preliminary inquiries has never exceeded seven, and during the greater part of the time has been limited to five, we submit that as great a degree of progress has been made in the applica- tion of the Act as could have been reasonably anticipated. We have now to state that 284 towns have memorialized and petitioned in form for the application of the Act. Of these, up to the 31st December 1853, the requisite forms and proceedings prescribed by the Act, have been complied with in 182, including nine in which the Act has been incorporated with local Acts, comprising altogether a total population, according to the census of 1851, of upwards of two millions — (2,100,000). Within the last three months we have had petitions for the application of the Act from upwards of twenty towns. Though, in many of the 1 82 towns, the application of the Act has been comparatively recent, yet, in one hundred and twenty-six cases, surveys with a view of carrying the Act into operation, have been completed or are in progress. In seventy, plans of new works founded on the surveys have been laid out. In thirty-one, including the cities of Gloucester, Salis- bury, and Ely, and the towns of Dover, Preston, Lancaster, Penzance, Wigan, and Chelmsford, plans of com- bined works for water supply and drainage have been submitted to the Board for examination, and have been approved ; mortgages of rates for the execution of these works have been sanctioned to the amount of upwards of 467,000/., and the works are now, for the most part, in progress. Besides the above sum for works entirely new, plans have been examined by the Board’s inspectors for works of drainage to combine with waterworks already existing ; for the extension of waterworks, and for other improve- ments contemplated by the Act, such as the paving and widening of streets, the opening of thoroughfares, the removal of obstructions to ventilation, &c. Plans, having reference to works of this description, have been examined and approved for thirty-nine towns ; and sanctions for the execution of these plans have been given to the amount of 589,000/., making a total sum, for which mortgages of rates have been sanctioned, of upwards of one million, viz. 1,056,000/. Expenditure for Sanitary Improvement of Towns. 15 In thirteen towns, including Rugby, Tottenham, Alnwick, Morpeth, Ilitchin, Ormskirk, Barnard Castle, St. Thomas, Exeter, Ottery St. Mary, Ashby-de-la-Zouch, and Launceston, the whole of the public works for water supply and drainage are completed, and reported to be in full action ; while the private portion, or that which connects the house drainage and water supply with the public works, is in rapid course of execution. With one excep- tion (that of Croydon, to which we shall subsequently advert), these works are reported to be working satisfac- torily:— that is to say, the main drainage works and the house drainage works, as far as they have been properly executed, are completely self-cleansing. It is expected that in about thirty-five other towns combined public works will be completed, and in full action, in less than a year. There will be further required an examination of sur- veys for fifty-seven towns, and of plans of works for one hundred and twelve towns. Supposing the cost of the execution of such plans, after examination and approval, to be at the same rate as the cost for similar works in the thirty-one towns for which sanctions have already been given, according to the closest proximate estimate that can be formed, there will be required for the public works in these towns 3,643,156/., and for their private works, at least 1,190,826/., making altogether a total sum of 4,833,980/. The rise in the price of labour and materials since those sanctions were given, will, how- ever, if they should continue at the present rates, augment the total expenditure to upwards of 6,000,000/. This estimate has respect only to the sum which will probably be required for town and house drainage, and water supply ; being, for water supply brought to every house, ’ an average of a penny halfpenny (1|.c 5t CO tJ Oi Mft cj o i. Be. c *2 a . *2 •Sc . 3 G -< 3 ^ O c c- o eft ^Oft *-> w> 0.3 C Cl. O O S-3"- la « Q •So S*t? H ’> ° « - ? CO ft w3 o 2 ©*g ,2 • tu. *rt w § <"g I 8* S CO ’O — • cd a p-3 g .o R . to So .5 cj 4J o ^ hn .a bo c •g 3 3 *“5 £ O S 3 | § >* « „•§ o° O^O. k‘s.5 i" S* «t!?s £5 3. S2oab«g? *J t- c ■•« T3 *C 2? 2=2,o c o!2> «3 3 o u S| r l > ■6^. £; S “ 8 u g2Sg‘-a . ££§•*2 | r O W ? cl il J- o a* 3 cj St Jr >- 3 > §°* s CJ O o =3 O S-i 3 O > • y *” O &2 S *-* «4_ • ' 3 S si Sib o o 3 — c* _S • “ C o 1^3 w2« - cj © aJ c *« & »Q ft- 1 o "3 o 0^3 S3 2 *2 = _ too O > o AM S C 8 c *G Cft to Q •a ftft 8 u =3 a 3 0 1 T3 G fc> X W > S & s o *G P« 13 •g cu C/2 E© 'If £2 E2 2 o hr •3 § h * fill 35 ^gco ■“'20 2 Po X e© « CJ 'P c §•-: &Sg i «i™ P. . go « O <«?9 • 00^ rj to £- 23 ■““•go?!, — °0 "■* X 3; g’&te g 05? S'EgSf'>g ■P g £ . « to w to CftC IE fi* river and «3 > *G *o g well or 1 'P s . §1 05 ft4 O O M £> £ to '3 £ TJ c rt and pump; neral, anc water col. fi on roofs a m P« • e a £w sunk in th< , sometime! sh from ses Wate) small. The i wells. CJ Deep 11 S'S 8 *3 Pumps and w CO ftU B 3 Ph Wells In ge rain - lected - hi CO QJ "g-fc Wells i beach, bracki water, works So &3 B s d “0 t >1- 2-=-S b «3 3 5* ^2« : rt C J4 | a) oo SH 14 *c - a n a M o m o X W fes ► « « 2 o«*- *c it c WL CJ R *“ U . to C l§i I &6 .-1 3 O ^iS s <5 M Q • • a £ s S & 5 ° Is |S * O Q O Ct U >* 0 « s w ^ gn ow % 1 H O H CD a D « o? og HW w 2: o H O s 88 House Drainage and Sewerage of Sites of Towns. No. VII.— Conclusions obtained as to House Drainage and the Sewerage and cleansing of Sites of Towns. In addition to tlie conclusions set forth in the Report on the Sanitary Condition of the Labouring Population, and confirmed and adopted by the Commissioners for inquiring into the means of improving the Health of Towns, namely, — That no population living amidst aerial impurities, arising from putrid emanations from cesspools, drains, or sewers of deposit, can be healthy, or free from tho attacks of devastating epidemics ; and — That, as a primary condition of salubrity, no ordure and town refuse can be permitted to remain beneath or near habitations ; — and, that by no means can remedial operations be so conveniently, economically, inoffensively, and quickly effected as by the removal of all such refuse dissolved or suspended in water; maybe enume- rated the following : — That it has been subsequently proved by the results of draining houses with tubular drains, in upwards of 19,000 cases, and by the trial of more than 200 miles of pipe-sewers, that the practice of constructing large brick or stone sewers for general town drainage, which detain matters passing into them in suspension in water, which accumulate deposit, and which are made large enough for men to enter them to remove the deposit by hand-labour, without reference to the area to be drained, has been in ignorance, neglect, or perversion of the above-recited principles. That whilst sewers so constructed are productive of great injury to the public health, by the diffusion into houses and streets of the noxious products of the decomposing matter contained in them, they are wasteful from the increased expense of their construction and repair, and from the cost of ineffectual efforts to keep them free from deposit. That the house-drains, made as they have heretofore been of absorbentbrick or stone, besides detaining substances in suspension, accumulating foul deposit, and being so permeable as to permit the escape of liquid and gaseous matters, are also false in principle, and wasteful in the expense of construction, cleansing, and repair. That it results from the experience of works constructed upon the principles developed in these inquiries, that improved tubular house-drains and sewers of the proper sizes, inclinations, and material, detain and accumulate no deposit, emit no offensive smells, and require no additional supplies of water to keep them clear. That, under a proper system of works for water supply combined with house and town drainage, such as is contemplated and sanctioned by the Public Health Act, no ordure is detained so long as to allow it to enter into advanced stages of decomposition, cither in the house-drains or in the public sewers ; but that all refuse is put in course of constant and inoffensive removal, at a rate of discharge of about three miles an hour. That where the absence of a natural fall impedes the continuous removal of town refuse, and of surplus rain or spring water, an artificial fall may be obtained by steam power, at a rate of cost (on House Drainage and Sewerage of Sites of Towns. 89 a scale for a large district) which is inconsiderable compared with the evils it would obviate ; and that, at such rate of cost, or from Is. to 2s. per house per annum, in many cases, not only may the house-refuse be removed from near habitations, but the foundations of houses and the whole sites of towns may be relieved from the damp of low-lying districts, and the consequent excessive unhealth- fulness and decay of habitations thereon diminished. That all offensive smells proceeding from any works intended for house or town drainage, indicate the fact of the detention and decomposition of ordure, and afford decisive evidence of malcon- struction, or of ignorant or defective arrangement. That the method of removing refuse in suspension in water, by properly combined works, is much cheaper than that of collecting it in pits or cesspools, near or underneath houses, emptying it by hand-labour, and removing it by cartage. That by a proper system of combined works, and properly adjusted tubular draiuage, three districts at the least may, under ordinary circumstances, be drained and supplied with water com- pletely at a rate of expense heretofore incurred in one for imper- fect works, which accumulate decomposing deposits, and gave off offensive and injurious smells. That under ordinary circumstances, where new and combined works are properly executed, the expense of the main water sup- plies, and the main drainage works have, on the average of the whole town, been less than at the rate of 3d. per house per week. That where combined works have been properly constructed, a service-pipe has been introduced from the water-main for the con- veyance of a constant supply of water, a sink and dust-bin pro- vided, the cesspool filled up, and an apparatus of the nature of a water-closet substituted, connected by a house-drain with a main drain or sewer, and put in good action, at a charge under ordinary circumstances, and for the greatest number of habitations, payable by an improvement rate of little more than 3d. weekly, being less than the ordinary rates of expense for forming and keeping in repair common pumps, and the expense of cleansing cesspools attached to houses in towns That where combined works have been properly executed, the expense of the complete works has not hitherto exceeded the average expense of cleansing and repairing house-drains, and of cleansing cesspools, as declared upon a house-to-house inquiry, including 8,000 houses, in three average parishes of the metro- polis. That it is important, for the sake of economy, as well as for the health of the population, that the practice of the removal of refuse in suspension in water, and by combined works should be applied to all houses, especially to those occupied by the poorest classes. 90 Conclusions obtained on Application of Sewer Water VIII. — Conclusions obtained as to the Drainage of Suburban Lands. 1. Excess of moisture, even on lands not evidently wet, is a cause of fogs and damps. 2. Dampness serves as the medium of conveyance for any decomposing matter that may be evolved, and adds to the injurious effects of such matter in the air : — in other words, the excess of moisture may be said to increase or aggravate atmospheric impurity. 3. The evaporation of the surplus moisture lowers temperature, produces chills, and creates or aggravates the sudden and in- jurious changes or fluctuations of temperature by which health is injured. ( Vide Sanitary Deport 1842, pp. 80-92; Second and Third Metropolitan Sanitary Deports, and postea, pp. 66-69.) The following are the chief agricultural advantages of land drainage to individual occupiers or owners : — 1st. By removing that excess of moisture which prevents the permeation of the soil by air, and obstructs the free assimilation of nourishing matter by the plants. 2d. By facilitating the absorption of manure by the soil, and so diminishing its loss by surface evaporation, and being washed away during heavy rains. 3d. By preventing the lowering of the temperature and the chilling of the vegetation, diminishing the effect of solar warmth not on the surface merely, but at the depth occupied by the roots of plants. 4th. By removing obstructions to the free working of the land, arising from the surface being at certain times, from excess of moisture, too soft to be worked upon, and liable to be poached by cattle. 5th. By preventing injuries to cattle or other stock, correspond- ing to the effects produced on human beings by marsh miasma, chills, and colds, inducing a general low state of health, and in extreme cases the rot or typhus. 6th. By diminishing damp at the foundations of houses, cattle sheds, and farm steadings, which causes their decay and dilapida- tion as well as discomfort and disease to inmates and cattle. IX. — Conclusions obtained on Application of Sewer Water and Town Manures to Agricultural Production. The general aspect and important sanitary relation of the subject are thus described in the Sanitary Deport of 1842 : — “ Within many of the towns we find the houses and streets “ filthy, the air foetid ; disease, typhus, and other epidemics rife “ amongst the population, bringing in their train destitution, and “ the need of pecuniary as well as medical relief, all mainly arising “ from the presence of the richest materials of production, the com- “ plete absence of which would, in a great measure, restore health, “ avert the recurrence of disease, and, if properly applied, would And Town Manures to Agricultural Production. 91 “ promote abundance, cheapen food, and increase the demand for A d f hs, Diseases. niEi w o J3 ? ■s'Jl a>-*c ’-n p. 35 $ Total. ft 811 33-2 8,557 33- 3,161 23- 160 2-4 673 2-8 1,330 9'7 709 1-4 454 1-9 923 &7 774 j'6 568 2-3 998 7-3 790 1-6 757 3-1 982 7-2 816 1-7 821 3-3 833 6- 799 1’6 849 3-3 719 3-2 129 2-3 987 4 ■ 670 3- 148 275 2-3 2-6 1,082 1,191 4% 4-9 603 629 4-4 4-6 592 29 1,353 3-3 529 3% 716 3-5 1,551 63 472 3-8 233 4-6 1.592 6-3 438 3-3 448 5 ■ 1,533 6-3 352 2-8 538 52 1,240 3- 296 2- 201 4-7 801 3-3 298 2- 389 2-2 343 1-4 181 1-3 437 ■9 108 •4 100 7 73 •2 19 •06? 35 •2 16 ■04 4 •02 6 •06 28 ■06 9 4o4 165 1-2 574 100 24,492 100 13,720 100 11-5 YiYrs.M. i 2G-4 3'8 Yrs.M. 33- 33 Yrs.M. 27-2 44,089 33% 158,815 37-7 3,352 2-6 19,137 4'3 1,981 1'5 10,431 2-5 1,889 1.4 13,741 3-3 2,190 1-7 16,565 4 • 2,384 1-8 15,406 3-6 2,648 2- 14,249 3-4 2,921 2-2 14,220 3-4 3,101 2-3 13,826 3-3 3,329 2-5 13,597 3-2 3,725 2-8 13,665 3-3 4,370 3-3 14,597 3-3 5,909 4-3 17,428 4-1 7,453 3-6 18,543 4'4 10,644 8- 20,717 3- 11,968 9-1 19,909 '4-7 10,511 8- 14,450 3-4 6,280 4-8 7,867 1-9 2,219 1-7 2,577 ■6 767 ■7 840 •2 115 •1 397 ■09 31,835 100 420,977 100 31-3 Yrs.M. 41-9 100 Yrs.M. 31-1 G 7 Ill APPENDIX XIV 112 Cost in Life of War and Pestilence > HH M P •25 P Ph Ph P o £ P P o I— I *> HH o A S »g p 12 T3 g» Sw Sd O -a* « 00 Ph — . .5 rt P c o o C'3 ^ ° g d A °<2 ■§p ~ o o ■u. £ ~ o bo w o rt o *3 «S§ Sf|§ c -u 3 rt cU to . p -d£§ O 3 *flg w 50 rt H 3 » s-g 5S^5 ? 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